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Assessing methamphetamine-related cue reactivity in people with methamphetamine use disorder relative to controls
Alexandre A Guerin1, Katherine D Drummond1, Yvonne Bonomo2
1Mental Health Theme, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3052, Australia; Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3052, Australia.
Abstract:
Methamphetamine use disorder involves methamphetamine-related cues invoking intense craving leading to relapse. Such cue reactivity is thought to arise from Pavlovian conditioning that occurs during the drug-taking experience. Cue reactivity then should be selective to methamphetamine cues (and not other cues), and not observed in people who have never experienced methamphetamine. However, these premises have never been tested and reported using objective measures such as skin conductance response (SCR). The primary aim of this study was to test these premises using a cue reactivity paradigm we developed using control cues. The secondary aim was to explore the relationship between cue reactivity, drug use characteristics, and cognition. Thirty people with a current diagnosis of methamphetamine use disorder and 30 matched controls with no history of substance use disorder were recruited. We observed higher overall subjective reactivity (F = 62.810; p < 0.001) and cue-selective physiological reactivity (F = 5.160; p = 0.026) in people with methamphetamine use disorder but not in controls. Co-morbid sedative use was associated with higher subjective craving (r = 0.521; p = 0.003). People who use methamphetamine intravenously had higher cue-selective SCR than smokers (t = 3.750; p < 0.001). Low inhibitory control measured by the Stroop task was associated with increased craving across the cue paradigm (r = -0.494; p = 0.006). Overall, these results support that cue reactivity in people with methamphetamine use disorder is due to Pavlovian conditioning. Its association with drug use and cognition highlights cue reactivity paradigm's utility in understanding methamphetamine use disorder to develop new treatments targeting cue-induced craving.
Insights
Methamphetamine use disorder triggers intense craving through drug-related cues, a phenomenon supported by Pavlovian conditioning. This study objectively measured cue reactivity, finding it specific to individuals with methamphetamine use disorder and linked to drug use patterns and cognitive function.
Area of Science:
- Neuroscience
- Psychology
- Addiction Medicine
Background:
- Methamphetamine use disorder (MUD) is characterized by intense craving in response to drug-related cues, often leading to relapse.
- This cue reactivity is hypothesized to stem from Pavlovian conditioning during drug use.
- Previous research lacked objective measures like skin conductance response (SCR) to validate these premises.
Purpose of the Study:
- To test the premises of cue reactivity in MUD using a novel cue reactivity paradigm with control cues.
- To objectively measure cue-selective physiological and subjective reactivity in individuals with MUD compared to controls.
- To explore associations between cue reactivity, drug use characteristics, and cognitive functions.
Main Methods:
- Recruited 30 individuals with MUD and 30 matched controls with no substance use history.
- Employed a cue reactivity paradigm presenting methamphetamine-related and control cues.
- Measured subjective craving and physiological responses, including skin conductance response (SCR).
- Assessed drug use characteristics and cognitive functions (e.g., Stroop task for inhibitory control).
Main Results:
- Individuals with MUD exhibited significantly higher subjective reactivity and cue-selective physiological reactivity compared to controls.
- Co-occurring sedative use correlated with increased subjective craving.
- Intravenous methamphetamine users showed higher cue-selective SCR than smokers.
- Lower inhibitory control was associated with heightened craving during the cue paradigm.
Conclusions:
- The findings support the Pavlovian conditioning model of cue reactivity in MUD.
- Cue reactivity is specific to individuals with MUD and not observed in controls.
- The developed cue reactivity paradigm is a valuable tool for understanding MUD.
- Associations with drug use and cognition suggest potential therapeutic targets for cue-induced craving.
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